NPIMap

Organization Active NPI

Midwest Foot and Ankle Clinic LLC

  • Podiatrist
  • Hicksville, OH
National Provider Identifier
1376211839
Registry record updated Aug 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
MIDWEST FOOT AND ANKLE CLINIC LLC
Practice address
208 Columbus St Ste 200
Hicksville, OH 43526-1250
Phone
(419) 799-1180
NPI assigned
Aug 31, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Nitie I SroaNPI 1215236864
Title
DPM
Phone
(419) 799-1180

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X Primary

Addresses

Primary practice location

208 Columbus St Ste 200
Hicksville, OH 43526-1250

Mailing address

208 Columbus St Ste 200
Hicksville, OH 43526-1250
Phone (419) 799-1180

Other identifiers 1

IdentifierTypeStateIssuer
300051280MedicaidIN

National Provider Directory

National Provider Directory
Tax ID family
Midwest Foot and Ankle Clinic LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1630368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630368000000",
    "number": "1376211839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 COLUMBUS ST STE 200",
            "city": "HICKSVILLE",
            "state": "OH",
            "postal_code": "435261250",
            "telephone_number": "419-799-1180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 COLUMBUS ST STE 200",
            "city": "HICKSVILLE",
            "state": "OH",
            "postal_code": "435261250",
            "telephone_number": "419-799-1180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST FOOT AND ANKLE CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-31",
        "last_updated": "2021-08-31",
        "certification_date": "2021-07-22",
        "status": "A",
        "authorized_official_last_name": "SROA",
        "authorized_official_first_name": "NITIE",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "DPM",
        "authorized_official_telephone_number": "419-799-1180"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300051280",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hicksville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.